{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:02:54Z","timestamp":1772211774319,"version":"3.50.1"},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Hexapod-ring-fixators have a characteristic rattling sound during load changes due to play in the hexapod struts. This play is perceived as unpleasant by patients and can lead to frame instability. Using slotted-ball-instead of universal-joints for the ring-strut connection could potentially resolve this problem. The purpose of the study was to clarify if the use of slotted-ball-joints reduces play and also fracture gap movement. A hexapod-fixator with slotted-ball-joints and aluminum struts (Ball-Al) was compared to\u00a0universal-joint-fixators with either aluminum (Uni Al) or\u00a0steel struts (Uni Steel). Six fixator frames each were loaded in tension, compression, torsion, bending and shear and\u00a0mechanical performance was analyzed in terms of movement, stiffness and play. The slotted-ball-joint fixator was\u00a0the only system without measurable axial play\u00a0(&lt;0.01\u00a0mm) compared to Uni-Al (1.2\u00a0\u00b1\u00a00.1)\u00a0mm and Uni-Steel (0.6\u00a0\u00b1\u00a00.2)\u00a0mm (<jats:italic>p<\/jats:italic>\u22640.001). In both shear directions the Uni-Al had the largest play (<jats:italic>p<\/jats:italic>\u22640.014). The resulting axial fracture gap movements were similar for the two aluminum frames and up to 25% smaller for the steel frame, mainly due to the highest stiffness found for the Uni-Steel in all\u00a0loading scenarios (<jats:italic>p<\/jats:italic>\u22640.036). However, the Uni-Steel construct was also up to 29% (450\u00a0g) heavier and had fewer usable mounting holes. In conclusion, the slotted-ball-joints of the Ball-Al fixator reduced play and minimized shear movement in the fracture while maintaining low weight of the construct. The heavier and stiffer Uni-Steel fixator compensates for existing play with a higher overall stiffness.<\/jats:p>","DOI":"10.1515\/bmt-2020-0323","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:10:25Z","timestamp":1625875825000},"page":"529-536","source":"Crossref","is-referenced-by-count":3,"title":["No more rattling: biomechanical evaluation of a hexapod ring fixator free of play"],"prefix":"10.1515","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5198-3153","authenticated-orcid":false,"given":"Markus","family":"Greinwald","sequence":"first","affiliation":[{"name":"Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau , Murnau , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily K.","family":"Bliven","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau , Murnau , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Trompeter","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery , St George\u2019s University Hospital , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-2128","authenticated-orcid":false,"given":"Peter","family":"Augat","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau , Murnau , Germany"},{"name":"Institute for Biomechanics, Paracelsus Medical University , Salzburg , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"key":"2023033112020967163_j_bmt-2020-0323_ref_001","doi-asserted-by":"crossref","unstructured":"Seide, K, Wolter, D, Kortmann, HR. Fracture reduction and deformity correction with the hexapod Ilizarov fixator. Clin Orthop Relat Res 1999:186\u201395https:\/\/doi.org\/10.1097\/00003086-199906000-00025.","DOI":"10.1097\/00003086-199906000-00025"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_002","doi-asserted-by":"crossref","unstructured":"Patel, M, Herzenberg, JE. Current trends in limb lengthening. Curr Opin Orthop 2000;11:431\u20137. https:\/\/doi.org\/10.1097\/00001433-200012000-00002.","DOI":"10.1097\/00001433-200012000-00002"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_003","doi-asserted-by":"crossref","unstructured":"AL-Sayyad, MJ. Taylor Spatial Frame in the treatment of pediatric and adolescent tibial shaft fractures. J Pediatr Orthop 2006;26:164\u201370. https:\/\/doi.org\/10.1097\/01.bpo.0000218522.05868.f9.","DOI":"10.1097\/01.bpo.0000218522.05868.f9"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_004","unstructured":"Smitham, P, Khan, W, Hazlerigg, A, Bajaj, S, McCarthy, I, Calder, P. Defining the rattle: a mechanical study of three different types of limb reconstruction frames. Orthop Proc 2012:42."},{"key":"2023033112020967163_j_bmt-2020-0323_ref_005","doi-asserted-by":"crossref","unstructured":"Henderson, ER, Feldman, DS, Lusk, C, van Bosse, HJ, Sala, D, Kummer, FJ. Conformational instability of the Taylor Spatial Frame: a case report and biomechanical study. J Pediatr Orthop 2008;28:471\u20137. https:\/\/doi.org\/10.1097\/bpo.0b013e318173ecb1.","DOI":"10.1097\/BPO.0b013e318173ecb1"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_006","doi-asserted-by":"crossref","unstructured":"Bliven, EK, Greinwald, M, Hackl, S, Augat, P. External fixation of the lower extremities: biomechanical perspective and recent innovations. Injury 2019;50:S10\u20137. https:\/\/doi.org\/10.1016\/j.injury.2019.03.041.","DOI":"10.1016\/j.injury.2019.03.041"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_007","doi-asserted-by":"crossref","unstructured":"Naude, J, Manjra, M, Birkholtz, FF, Barnard, A-C, Glatt, V, Tetsworth, K, et al.. Outcomes following treatment of complex tibial fractures with circular external fixation: a comparison between the Taylor Spatial Frame and TrueLok-Hex. Strategies Trauma Limb Reconstr 2019;14:142. https:\/\/doi.org\/10.5005\/jp-journals-10080-1443.","DOI":"10.5005\/jp-journals-10080-1443"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_008","unstructured":"Ferreira, N, Birkholtz, F, Marais, L. Tibial non-union treated with the TL-Hex: a case report. SA Orthop J 2015;14:44\u20137."},{"key":"2023033112020967163_j_bmt-2020-0323_ref_009","doi-asserted-by":"crossref","unstructured":"Riganti, S, Nasto, LA, Mannino, S, Marr\u00e8 Brunenghi, G, Boero, S. Correction of complex lower limb angular deformities with or\u00a0without length discrepancy in children using the TL-HEX\u00a0hexapod system: comparison of clinical and radiographical results. J Pediatr Orthop B 2019;28:214\u201320. https:\/\/doi.org\/10.1097\/bpb.0000000000000573.","DOI":"10.1097\/BPB.0000000000000573"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_010","doi-asserted-by":"crossref","unstructured":"Henderson, DJ, Rushbrook, JL, Harwood, PJ, Stewart, TD. What are the biomechanical properties of the Taylor Spatial Frame? Clin Orthop Relat Res 2017;475:1472\u201382. https:\/\/doi.org\/10.1007\/s11999-016-5182-8.","DOI":"10.1007\/s11999-016-5182-8"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_011","doi-asserted-by":"crossref","unstructured":"Khurana, A, Byrne, C, Evans, S, Tanaka, H, Haraharan, K. Comparison of transverse wires and half pins in Taylor Spatial Frame: a biomechanical study. J Orthop Surg Res 2010;5:23. https:\/\/doi.org\/10.1186\/1749-799x-5-23.","DOI":"10.1186\/1749-799X-5-23"},{"key":"2023033112020967163_j_bmt-2020-0323_ref_012","doi-asserted-by":"crossref","unstructured":"Henderson, DJ, Rushbrook, JL, Stewart, TD, Harwood, PJ. What are the biomechanical effects of half-pin and fine-wire configurations on fracture site movement in circular frames? Clin Orthop Relat Res 2016;474:1041\u20139. https:\/\/doi.org\/10.1007\/s11999-015-4652-8.","DOI":"10.1007\/s11999-015-4652-8"}],"container-title":["Biomedical Engineering \/ Biomedizinische Technik"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/bmt-2020-0323\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/bmt-2020-0323\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T16:29:20Z","timestamp":1680280160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/bmt-2020-0323\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,9]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,3]]},"published-print":{"date-parts":[[2021,10,26]]}},"alternative-id":["10.1515\/bmt-2020-0323"],"URL":"https:\/\/doi.org\/10.1515\/bmt-2020-0323","relation":{},"ISSN":["0013-5585","1862-278X"],"issn-type":[{"value":"0013-5585","type":"print"},{"value":"1862-278X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,9]]}}}